While some studies suggest that Black Americans get rheumatoid arthritis (RA) at around the same rate as white people, some doctors are concerned that might not be the case. One possible reason is that fewer Black people are included in randomized studies or clinical trials. In any case, many Black Americans don’t get diagnosed at the early stages of RA and might suffer from the effects of the disease’s progression.
The Stages of RA
1. Early-stage RA
The symptoms of early-stage RA usually aren’t as noticeable as the later ones so it’s rare for the disease to be diagnosed at this point. However, if it is, the disease is more likely to go into remission with continuous treatment. Some of the symptoms you see at this stage include mild joint pain, slight swelling, and moderate fatigue. Though the tissue around your joints may swell, there’s no damage to the joints at this stage. You may receive non-steroidal inflammatory drugs (NSAIDs) to manage pain and swelling as well as antirheumatic drugs to suppress your immune system.
2. Moderate-stage RA
At this stage, tissue inflammation starts to cause damage to your joint cartilage and bone. That’s why you start to experience joint pain and stiffness that affects your range of motion or mobility. You may have trouble bending your fingers or holding things tightly. Your treatment options at stage two usually include NSAIDs and antirheumatic drugs. Depending on your symptoms, your doctor may explore biologics as they work on your immune system to change its response.
3. Severe RA
In severe RA, cartilage damage worsens and bone destruction gets worse. The fluid between your joints starts to wear away so your bones rub together and cause significant pain. While you can expect to have pain and swelling, some people also have muscle weakness, mobility loss, tendon compression, and symptoms of carpal tunnel syndrome. This is also the stage at which you may start to see damage and malformation of the joints like twisted fingers or thickened knuckles. Sometimes, these issues are permanent. At stage 3, your doctor will likely prescribe the same medications as stage 2 but may also explore surgical options.
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4. End-stage RA
This last stage of RA is characterized by pain, swelling, stiffness, and mobility loss though your joints no longer show signs of inflammation. You may also have lower muscle strength, poor function in your hands, a hard time bending your knees, and difficulty flexing your hips. In some people, the bones may begin to fuse. While you’ll still need medication to deal with the symptoms of your RA, surgery may become the only way to make a difference. For example, surgery may replace affected joints, remove affected nodules, or repair tendons.
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How to Slow the Disease’s Progression
As a chronic disease, RA is likely to progress from one stage to the other – especially if you’re not undergoing treatment. There are certain medications or therapies that your doctor may prescribe to slow the disease’s progression so you don’t get to the painful end stage. These can include disease-modifying antirheumatic drugs protecting your joint tissue by suppressing your body’s immune and inflammatory responses.
Experts also suggest making a few lifestyle changes to complement your medical regimen. Moderate exercise, eating an anti-inflammatory diet, and maintaining a healthy weight can help to manage your RA. If you smoke, it’s best to stop as this can affect your treatment. Additionally, chronic stress has been shown to make RA symptoms worse so you should talk to your doctor about effective stress management options.
While the signs of the disease’s progression can vary, it’s typically characterized by worsening symptoms. People with RA usually have flares interspersed with periods of remission. During a flare, symptoms such as joint pain and swelling get worse, and during remission, they’ll be pain-free. As the disease progresses, the periods of remission become shorter while the flares last longer. For some people, the final stage of RA has little to no remission.
If you’ve been diagnosed with RA, it’s important to know which stage you’re dealing with so you can get the right treatment. Given how badly the later stages of RA can affect your daily life, you should talk to your doctor immediately about slowing the progression of the disease.
